Predictors of stroke in patients undergoing cardiac surgery

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 29; no. 2; pp. 140 - 147
• Main Authors: Santos, Handerson Nunes dos, Magedanz, Ellen Hettwer, Guaragna, João Carlos Vieira da Costa, Santos, Natalia Nunes dos, Albuquerque, Luciano Cabral, Goldani, Marco Antonio, Petracco, João Batista, Bodanese, Luiz Carlos
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01.04.2014
• Subjects: Acidente Vascular Cerebral; Adolescent; Adult; Aged; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Cardiology; Cohort Studies; Fatores de Risco; Female; Heart surgery; Hospital Mortality; Humans; Length of Stay; Logistic Models; Male; Middle Aged; Postoperative Complications; Procedimentos Cirúrgicos Cardíacos; Revascularização Miocárdica; Risk Assessment; Risk Factors; Stroke - etiology; Stroke - mortality; SURGERY; Time Factors; Valvas Cardíacas; Young Adult; Stroke; Cardiac Surgical Procedures; Revascularização Miocárdica; Heart Valves; Risk Factors; Valvas Cardíacas; Acidente Vascular Cerebral; Procedimentos Cirúrgicos Cardíacos; Fatores de Risco; Myocardial Revascularization
• ISSN: 0102-7638; 1678-9741; 1678-9741
• DOI: 10.5935/1678-9741.20140025

To determine the risk factors related to the development of stroke in patients undergoing cardiac surgery. A historical cohort study. We included 4626 patients aged > 18 years who underwent coronary artery bypass surgery, heart valve replacement surgery alone or heart valve surgery combined with coronary artery bypass grafting between January 1996 and December 2011. The relationship between risk predictors and stroke was assessed by logistic regression model with a significance level of 0.05. The incidence of stroke was 3% in the overall sample. After logistic regression, the following risk predictors for stroke were found: age 50-65 years (OR=2.11 - 95% CI 1.05-4.23 - P=0.036) and age >66 years (OR=3.22 - 95% CI 1.6-6.47 - P=0.001), urgent and emergency surgery (OR=2.03 - 95% CI 1.20-3.45 - P=0.008), aortic valve disease (OR=2.32 - 95% CI 1.18-4.56 - P=0.014), history of atrial fibrillation (OR=1.88 - 95% CI 1.05-3.34 - P=0.032), peripheral artery disease (OR=1.81 - 95% CI 1.13-2.92 - P=0.014), history of cerebrovascular disease (OR=3.42 - 95% CI 2.19-5.35 - P<0.001) and cardiopulmonary bypass time > 110 minutes (OR=1.71 - 95% CI 1.16-2.53 - P=0.007). Mortality was 31.9% in the stroke group and 8.5% in the control group (OR=5.06 - 95% CI 3.5-7.33 - P<0.001). The study identified the following risk predictors for stroke after cardiac surgery: age, urgent and emergency surgery, aortic valve disease, history of atrial fibrillation, peripheral artery disease, history of cerebrovascular disease and cardiopulmonary bypass time > 110 minutes.